哮喘联盟

   摘要
   目的：严重精神疾病患者吸烟的概率大大高于普通人群。咨询和药物治疗相结合的戒烟疗法效果尚可，但戒烟成功率仍较低。另外，严重精神疾病患者在戒烟干预措施中的体验相关研究很少。为了补充这方面认识的空白，我们进行了一项定性研究，以对促进或阻碍严重精神疾病患者群体戒烟的相关因素进行调查。
   方法：我们纳入了16例患有严重精神疾病的吸烟者，他们都曾参加关于两种戒烟干预措施的临床试验。其中一种仅使用尼古丁替代治疗，另外一种在尼古丁替代治疗的同时进行鼓励性谈话及同伴的支持互助。16例患者的年龄在20－56岁之间，性别平均分布（8例男性和8例女性），并且主要为高加索人（n = 13，81%），对他们进行开放式、半结构式的访谈。主要的精神疾病包括精神分裂症/情感分裂症（n = 6，38%）、抑郁（n = 5，31%）、躁虑症（n = 4，25%）以及焦虑症（n = 1，6%）等。所有患者入组时平均每天的吸烟量为22.6支（SD = 13.0）。
   结果：研究结果显示，严重精神疾病患者对相同戒烟疗法的体验有很大的不同。其戒烟体验与干预措施本身（戒烟帮助、团体支持、对个人选择和需求的强调等）、个人因素（心理健康、生理健康和药物滥用）以及社会环境因素（困难的生活事件和社会关系）均相关。
   结论：对严重精神疾病患者戒烟体验的进一步了解将有助于制定更适合这一群体的戒烟干预措施。本项目的研究结果提示在戒烟干预措施中提供多样化治疗方案的重要性，使其更具有选择性和灵活性，并且可以响应每一个患者的需求和喜好。
 

（刘国梁 审校）
J Dual Diagn. 2014 Dec 9:0. [Epub ahead of print]


 

Factors Affecting Smoking Cessation Efforts of People with Severe Mental Illness: A Qualitative Study.
 

Rae J1, Pettey D, Aubry T, Stol J.
 

Abstract
OBJECTIVE: People with severe mental illness are much more likely to smoke than are members of the general population. Smoking cessation interventions that combine counseling and medication have been shown to be moderately effective, but quit rates remain low and little is known about the experiences of people with severe mental illness in smoking cessation interventions. To address this gap in knowledge, we conducted a qualitative study to investigate factors that help or hinder the smoking cessation efforts of people with severe mental illness.
METHODS: We recruited 16 people with severe mental illness who had participated in a clinical trial of two different smoking cessation interventions, one involving nicotine replacement therapy only and the other nicotine replacement therapy combined with motivational interviewing and a peer support group. We conducted open-ended, semi-structured interviews with participants, who ranged in age from 20 to 56 years old, were equally distributed by gender (8 men and 8 women), and were predominantly Caucasian (n = 13, 81%). Primary mental illness diagnoses included schizophrenia/schizoaffective disorder (n = 6, 38%), depression (n = 5, 31%), bipolar disorder (n = 4, 25%), and anxiety disorder (n = 1, 6%). At entry into the clinical trial, participants smoked an average of 22.6 cigarettes per day (SD = 13.0).
RESULTS: Results indicated that people with mental illness have a diverse range of experiences in the same smoking cessation intervention. Smoking cessation experiences were influenced by factors related to the intervention itself (such as presence of smoking cessation aids, group supports, and emphasis on individual choice and needs), as well as individual factors (such as mental health, physical health, and substance use), and social-environmental factors (such as difficult life events and social relationships).
CONCLUSIONS: An improved understanding of the smoking cessation experiences of people with severe mental illness can inform the delivery of future smoking cessation interventions for this population. The results of this study suggest the importance of smoking cessation interventions that offer a variety of treatment options, incorporating choice and flexibility, so as to be responsive to the evolving needs and preferences of individual clients.
 

J Dual Diagn. 2014 Dec 9:0. [Epub ahead of print]